Wang Qiuyue, Luo Nana, Lei Min, Chen Xian, Li Chunxiao, Hao Pingsheng
School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China.
Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China.
Clin Cosmet Investig Dermatol. 2022 Jul 17;15:1371-1376. doi: 10.2147/CCID.S373228. eCollection 2022.
Grover's disease (GD), also known as Transient acantholytic dermatosis, has no typical clinical rash features. It usually occurs in elderly white men but very rarely in China. This is a disease of acantholysis and dyskeratosis, which is usually considered to be spontaneous remission. The skin lesions of the disease are diverse, and the main symptom is severe itching. We have reported a case of GD in a 14-year-old Chinese Tibetan male whose clinical manifestations were pruritic red papule, generalized red papules, papulo vesicles and blisters ranging from millet rice to soybean size. Skin lesions change rapidly and variously. In order to confirm the diagnosis, we have done skin biopsies, immunofluorescence, dermoscopy, microscopy and other examinations. Pathological skin biopsy showed acantholysis. Intraepidermal blisters and the presence of blisters on the basal cells as well as under the stratum corneum can be observed on the same pathological section. Type IV collagen immunohistochemistry showed blisters in the epidermis. The diagnosis of GD depended on the exclusion of other diseases. After we performed whole exon sequencing (WES) on DNA from the patient's blood, pathogenic gene mutations were not found. Pustular psoriasis, Subcorneal pustular dermatosis, Herpesvirus infections, Dermatitis herpetiformis, Pemphigus vulgaris, Norwegian scabies, Darier's disease, and Hailey-Hailey disease were all excluded. We successfully treated adolescent GD with minocycline combined with methotrexate. The patient was followed up for 19 months without recurrence.
格罗弗病（GD），又称暂时性棘层松解性皮病，无典型的临床皮疹特征。该病通常发生于老年白人男性，在中国极为罕见。这是一种棘层松解和角化不良性疾病，通常被认为可自发缓解。该病的皮肤损害多样，主要症状为剧烈瘙痒。我们报告了1例14岁中国藏族男性格罗弗病患者，其临床表现为瘙痒性红色丘疹、泛发性红色丘疹、粟米至黄豆大小的丘疹水疱及水疱。皮肤损害变化迅速且多样。为明确诊断，我们进行了皮肤活检、免疫荧光、皮肤镜、显微镜检查等。皮肤病理活检显示棘层松解。在同一病理切片上可观察到表皮内水疱以及基底细胞层和角质层下的水疱。IV型胶原免疫组化显示表皮内水疱。格罗弗病的诊断依赖于排除其他疾病。我们对患者血液中的DNA进行全外显子测序（WES）后，未发现致病基因突变。脓疱型银屑病、角层下脓疱性皮病、疱疹病毒感染、疱疹样皮炎、寻常型天疱疮、挪威疥疮、达里埃病和黑利-黑利病均被排除。我们用米诺环素联合甲氨蝶呤成功治疗了青少年格罗弗病。对该患者随访19个月无复发。
